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Wayne PM, Vining R, Long CR, Burton WM, Litrownik D, Guzman J, Kilgore K, Hagan TJ, Rist PM, Kowalski MH. Combined chiropractic care and Tai Chi for chronic neck pain: A protocol for a pilot randomized trial. Contemp Clin Trials Commun 2025; 45:101482. [PMID: 40321971 PMCID: PMC12049832 DOI: 10.1016/j.conctc.2025.101482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Revised: 02/13/2025] [Accepted: 04/04/2025] [Indexed: 05/08/2025] Open
Abstract
Background Neck pain presents a personal and socioeconomic burden globally. Despite increasing prevalence, research on chronic neck pain (CNP) is limited and management relies on generalized approaches. There is growing interest in non-pharmacological interventions, however their efficacy remains uncertain due to the multifactorial etiology of CNP. Two interventions, multimodal chiropractic care (MCC) and Tai Chi, have shown promise individually in managing CNP, and when combined may offer synergistic benefits. This pilot study aims to assess the feasibility of combining these interventions for CNP.Methods/design: Forty-eight adults, aged 18-65y, with CNP defined as occurring ≥5 days a week for ≥3 consecutive months, severity of ≥3 on the numeric rating scale, and a score of ≥5 on the Neck Disability Index will be recruited. Participants will be randomized 1:1:1 to one of the three treatment groups (MCC plus Tai Chi and Enhanced Usual Care (EUC), MCC plus EUC, or EUC alone). The MCC was validated using a modified Delphi approach. Primary outcomes relate to feasibility (recruitment, retention, and adherence) and secondary outcomes include clinical measures of neck pain severity and disability, health-related quality-of-life, psychosocial well-being, and physical function. Outcomes will be assessed at baseline, 16-weeks (post-intervention), and 24-weeks. Qualitative interviews will be conducted. Discussion Results of this study will provide preliminary evidence regarding the feasibility and clinical evaluation of pragmatically delivered MCC, alone or in combination with Tai Chi, for individuals with CNP. These data will be used to inform the design of a fully powered, factorial trial evaluating two promising non-pharmacological therapies for CNP. Trial registration This study is registered in ClinicalTrials.gov (NCT05726331).
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Affiliation(s)
- Peter M. Wayne
- Osher Center for Integrative Health, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Robert Vining
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, USA
| | - Cynthia R. Long
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, USA
| | - Wren M. Burton
- Osher Center for Integrative Health, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel Litrownik
- Osher Center for Integrative Health, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jacqueline Guzman
- Osher Center for Integrative Health, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Karen Kilgore
- Osher Center for Integrative Health, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Pamela M. Rist
- Osher Center for Integrative Health, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Matthew H. Kowalski
- Osher Center for Integrative Health, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Dawson BD, Keller HE, Sawyer LM, Gorman S, Sabangan JA, McPartlin A, Payne S, Brown KJ, Li G, Sullivan DH. Evaluation of a Virtual Tai Chi Program for Older Veterans at Risk of Loneliness or Physical Deconditioning: A Quality Improvement Project. Geriatrics (Basel) 2024; 9:91. [PMID: 39051255 PMCID: PMC11270295 DOI: 10.3390/geriatrics9040091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/17/2024] [Accepted: 07/05/2024] [Indexed: 07/27/2024] Open
Abstract
This Quality Improvement project evaluated the implementation of a virtual Tai Chi program for older Veterans (OVs) at risk of loneliness and/or physical deconditioning. A 12-week Tai Chi course was conducted virtually at three Veterans Affairs sites using VA Video Connect (VVC). Changes in physical function based on the 30-Second Chair Stand (30CST) and loneliness based on the De Jong Gierveld Loneliness Scale (DJGS) were measured, as were the OVs' satisfaction and adherence. Of 109 OVs who enrolled, 74 completed the program with a mean attendance rate of 84%. Completers demonstrated a statistically significant improvement in the 30CST, and those who were moderately or severely lonely at baseline saw a statistically significant improvement in the DJGS. Course evaluations were generally very positive. Results suggest that a virtual Tai Chi program is an effective and very satisfying intervention for OVs at risk of loneliness or physical deconditioning.
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Affiliation(s)
- Bonnie D. Dawson
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114, USA; (H.E.K.); (L.M.S.); (D.H.S.)
| | - Hallie E. Keller
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114, USA; (H.E.K.); (L.M.S.); (D.H.S.)
| | - Linda M. Sawyer
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114, USA; (H.E.K.); (L.M.S.); (D.H.S.)
| | - Shannon Gorman
- VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA; (S.G.); (J.A.S.)
| | - Jerome A. Sabangan
- VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA; (S.G.); (J.A.S.)
| | - Adam McPartlin
- VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (A.M.); (S.P.); (K.J.B.); (G.L.)
| | - Sarah Payne
- VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (A.M.); (S.P.); (K.J.B.); (G.L.)
| | - Karl J. Brown
- VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (A.M.); (S.P.); (K.J.B.); (G.L.)
| | - Gail Li
- VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (A.M.); (S.P.); (K.J.B.); (G.L.)
| | - Dennis H. Sullivan
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114, USA; (H.E.K.); (L.M.S.); (D.H.S.)
- Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA
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González-Castro A, Leirós-Rodríguez R, Prada-García C, Benítez-Andrades JA. The Applications of Artificial Intelligence for Assessing Fall Risk: Systematic Review. J Med Internet Res 2024; 26:e54934. [PMID: 38684088 DOI: 10.2196/54934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/30/2024] [Accepted: 02/13/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Falls and their consequences are a serious public health problem worldwide. Each year, 37.3 million falls requiring medical attention occur. Therefore, the analysis of fall risk is of great importance for prevention. Artificial intelligence (AI) represents an innovative tool for creating predictive statistical models of fall risk through data analysis. OBJECTIVE The aim of this review was to analyze the available evidence on the applications of AI in the analysis of data related to postural control and fall risk. METHODS A literature search was conducted in 6 databases with the following inclusion criteria: the articles had to be published within the last 5 years (from 2018 to 2024), they had to apply some method of AI, AI analyses had to be applied to data from samples consisting of humans, and the analyzed sample had to consist of individuals with independent walking with or without the assistance of external orthopedic devices. RESULTS We obtained a total of 3858 articles, of which 22 were finally selected. Data extraction for subsequent analysis varied in the different studies: 82% (18/22) of them extracted data through tests or functional assessments, and the remaining 18% (4/22) of them extracted through existing medical records. Different AI techniques were used throughout the articles. All the research included in the review obtained accuracy values of >70% in the predictive models obtained through AI. CONCLUSIONS The use of AI proves to be a valuable tool for creating predictive models of fall risk. The use of this tool could have a significant socioeconomic impact as it enables the development of low-cost predictive models with a high level of accuracy. TRIAL REGISTRATION PROSPERO CRD42023443277; https://tinyurl.com/4sb72ssv.
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Affiliation(s)
- Ana González-Castro
- Nursing and Physical Therapy Department, Universidad de León, Ponferrada, Spain
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, Universidad de León, Ponferrada, Spain
| | - Camino Prada-García
- Department of Preventive Medicine and Public Health, Universidad de Valladolid, Valladolid, Spain
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Ibañez GE, Ahmed S, Hu N, Larkey L, Fennie KP, Lembo M, Huertas L. Acceptability and Feasibility of a Tai Chi/Qigong Intervention for Older People Living With HIV. AIDS Behav 2024; 28:1291-1300. [PMID: 37597056 PMCID: PMC11995360 DOI: 10.1007/s10461-023-04158-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 08/21/2023]
Abstract
Tai chi/qigong (TCQ) is a low impact, meditative movement with breathwork that may benefit people with HIV (PWH) over 50 years old. This study is a feasibility clinical trial of a remote TCQ intervention for older PWH. Participants (n = 48) were recruited via clinic sites and social media and randomized to a TCQ, sham qigong, or wait-list control group. The 12-week intervention included fourteen 45-60-minute sessions. Acceptability (satisfaction, attitudes, practice, attendance) and feasibility (retention rate, adverse events, remote delivery) data were surveyed. Overall retention rate was 72.9%, but 81.2% for the TCQ group. Most TCQ participants attended at least 10 sessions (62.5%) and were practicing TCQ after 2 weeks (72.7%). Over 92% of TCQ participants reported satisfaction and positive attitudes and preferred remote versus in person delivery (63.6%). Two mild intervention related adverse events occurred. Findings suggest that a remote TCQ intervention is acceptable, feasible, and safe among older PWH.
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Affiliation(s)
- Gladys E Ibañez
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA.
- Natural Sciences Division, New College of Florida, Sarasota, Fl, 34243, USA.
| | - Shyfuddin Ahmed
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA
| | - Nan Hu
- Department of Biostatistics, Florida International University, Miami, Fl, 33199, USA
| | - Linda Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, 85004, USA
| | - Kristopher P Fennie
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA
| | - Micaela Lembo
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA
| | - Laura Huertas
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA
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Sun Y, Tabeshian R, Mustafa H, Zehr EP. Using Martial Arts Training as Exercise Therapy Can Benefit All Ages. Exerc Sport Sci Rev 2024; 52:23-30. [PMID: 37699015 DOI: 10.1249/jes.0000000000000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
Martial arts training focuses on whole-body movement patterning, philosophy, interpersonal interactions, and functional self-defense. Such training has positive impacts on physical, psychological, and cognitive well-being in older adults and children with and without clinical conditions. We hypothesize that martial arts training can be delivered as a form of exercise therapy for people at all ages to enhance overall health.
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Affiliation(s)
| | - Roza Tabeshian
- Department of Motor Behavior, University of Isfahan, Isfahan, Iran
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